Mortons Neuroma?

[oldguy00]

Anyone here an expert on this??

For the past 2-3 weeks I find my 2nd, 3rd and 4th toes on both feet, maybe a little worse on one than the other, have been sore....maybe burning soreness, under the pads. But no pain under ball of foot, and none in big toes or pinky toes.
Not really -strictly- burning and not tingling, not really any discoloration. But sore to touch.

Wondering if Mortons could explain this?

I have, also for the past several years I think had a bit of 'reynauds' (sp?) where if I am on a cold floor my toes can go blue, but this is different, no discolor and always sore.

In good shape, no history of diabetes or MS or ALS etc in family. Active triathlete so my feet do take a bit of a pounding.

Yup, I have a doc appt, but not for about 10 days, takes a bit longer in Canada..

Edit - I should also add that I do struggle with shoe width, both in forefoot and midfoot, and do have orthotics with met pads. I actually have the bunion area cut out of my shimano tri shoes. But the thing that puzzled me about this is that whenever I read about mortons, it always seems to reference pain under ball of foot radiating up to toes, but I don't seem to have that, just mostly the last like centimeter of the 2nd-4th toes.

Cheers

[soulspinner]

had the issue since the 80s when I wore racing shoes too tight. Went to a doc that was a foot guy and he said its too bad for cortisone. Went to a foot performance store and have used orthotics that take pressure off the area where the neuroma is ever since.

[Tickdoc]

Went through this six or seven years ago. It was a painful annoyance. I visited a foot dr and had custom orthotics made. Wore them off and on for about a year and it eventually went away. Every now and then I will feel it try to flare up, but it hasn't gone full blown like it was. I remember it being a painfully hot pain centered right between the third and fourth toe connection to the foot. It would feel like it was on fire and was very painful at times.

May sound crazy, but I think mine was caused by a certain brand of shoe? (Timberland)I can't confirm this, but at the time I has three or four pairs of shoes from them and it coincided with the morton's. I wore the orthotics with all my shoes, even cycling, and eventually went away from those shoes and now I am good.

I discovered through that process that a metatarsal bump helps my feet when cycling and that Lake shoes with specialized insoles are my bag.

The other thing I noticed is that I went away from overly cushioned shoes and seemed to do better with flat leather shoes for work and negative heel ramped shoes for play. Then lastly, I started stretching about this time. Yoga and resistance stretching including the feet. I routinely splay my toes and lift myself up from say, downward dog or a plank using only my toes to further stretch all of the tendons of the foot.

Good luck to you and I hope yours gets better over time like mine did.

[quattro]

Originally Posted by oldguy00

Anyone here an expert on this??

For the past 2-3 weeks I find my 2nd, 3rd and 4th toes on both feet, maybe a little worse on one than the other, have been sore....maybe burning soreness, under the pads. But no pain under ball of foot, and none in big toes or pinky toes.
Not really -strictly- burning and not tingling, not really any discoloration. But sore to touch.

Wondering if Mortons could explain this?

I have, also for the past several years I think had a bit of 'reynauds' (sp?) where if I am on a cold floor my toes can go blue, but this is different, no discolor and always sore.

In good shape, no history of diabetes or MS or ALS etc in family. Active triathlete so my feet do take a bit of a pounding.

Yup, I have a doc appt, but not for about 10 days, takes a bit longer in Canada..

Edit - I should also add that I do struggle with shoe width, both in forefoot and midfoot, and do have orthotics with met pads. I actually have the bunion area cut out of my shimano tri shoes. But the thing that puzzled me about this is that whenever I read about mortons, it always seems to reference pain under ball of foot radiating up to toes, but I don't seem to have that, just mostly the last like centimeter of the 2nd-4th toes.

Cheers

Hey oldguy00, how are you doing? I've had Morton's Neuroma for years, well documented on this forum, LOL! Mine is in my left foot, second and third metatarsal area. I also have nonfat pad under the metatarsals due to cortisone shots in the foot, don't get them! Plus I have hammer toes, all of these things contribute to my issues, so my discomfort is probably different than what you are experiencing. I have tried many things over the years, I have custom orthotics for my everyday shoes, no longer use a metatarsal pad, what I have found is wide fitting shoes of every kind, sneakers, dress, hiking, cycling, etc, are what is needed to take the pressure of the nerves between the metatarsals. As recommended below, Lake cycling shoes have also worked very well for me,I ride the CX241 wide with custom cycling orthotics and can ride comfortably. Your Dr. hopefully will make the correct diagnosis and suggest how to deal with it going forward, you're on the right track. Good luck!

[oldguy00]

Thanks all. Always a bit nerve racking when checking 'Dr Google'...lol

[Veloo]

I have.
Flared up during a tour last summer.
My left foot is a bit messed up from teen years and prone to numbness. Three toes went numb (no pain) during the tour in June and while I'm not numb anymore, I can still feel a sensation on 2 toes today.
If you're in Toronto, I went to the specialist at Yonge and Eg NW corner tower and she basically said "they" don't really know the source of MN but there is a surgical procedure if it's bad. Otherwise she recommended I take it easy on the foot and hopefully it goes away.

https://forums.thepaceline.net/showthread.php?t=241074

[wallymann]

i've been dealing and trying to non-surgically manage mortons in my left foot.

the affected nerve is between the 3rd and 4th, is aggravated when cycling or running stairs -- so its worse during cycling season. burning sensation is quite unpleasant, starting from the pads under those toes radiating into the toes themselves. as i get in better shape (read: more force on pedals) it tends to worsen. when it gets bad-bad it does affect walking/running.

• i'm sure to have nice orthotics with a proper metatarsal pad in my cycling shoes.
• i've gone up 1/2 size in my cycling shoes so i can add another layer of insole padding under the orthotic.
• any pressure that draws the toes together is bad -- cycling shoes with just 2 straps is preferable, if there is a 3rd strap across the toes (like my sidi ergos) i leave it loose all the time.
• i've also taken to carefully cutting a hole in my insole just in front of the metatarsal pad directly under the affected nerve to minimize direct pressure.
• i try to stretch/massage the affected nerve before a workout/ride, which does seem to help.
• if it gets really bad i'll get a targeted cortisone injection.
• i'm very sure to have street-shoes with enough width in the forefoot to not compress my forefoot or toes together, often meaning i have to go up 1/2 size and adjust fit with insoles.

there is surgery to cut out the affected nerve, but that leaves you with permanent numbness in part of your foot/toes.

you can also achieve the same non-surgically with a targeted alcohol injection which basically kills the affected nerve.

i'm trying to avoid these.

[oldguy00]

Originally Posted by wallymann

i've been dealing and trying to non-surgically manage mortons in my left foot.

it affects the middle 3 toes and is aggravated when cycling or running stairs -- so its worse during cycling season. burning sensation is quite unpleasant, starting from the pads under those middle toes radiating to the toes themselves. as i get in better shape (read: more force on pedals) it tends to worsen. when it gets bad-bad it does affect walking/running.

• i'm sure to have nice orthotics with a proper metatarsal pad in my cycling shoes.
• i've gone up 1/2 size in my cycling shoes so i can add another layer of insole padding under the orthotic.
• i've also taken to carefully cutting a hole in my insole just in front of the metatarsal pad directly under the affected nerve to minimize direct pressure.
• i try to stretch/massage the affected nerve which does help.
• if it gets really bad i'll get a targeted cortisone injection.
• i'm very sure to have street-shoes with enough width in the forefoot to not compress my footbones together, often meaning i have to go up 1/2 size and adjust fit with insoles.

there is surgery to cut out the affected nerve, but that leaves you with permanent numbness in part of your foot/toes.

you can also achieve the same non-surgically with a targeted alcohol injection which basically kills the affected nerve.

i'm trying to avoid these.

Thanks. You guys would get a good laugh if you saw my collection of off the shelf, and custom, orthotics. And also got custom cycling shoes recently which haven't worked out so well, didn't fit right.
That said, my main purpose for getting orthotics in the past was to help with pain on the outside of my foot, which my podiatrist says is the styloid process....(used to think those were only on the wrists!).

Wallymann - what do you do for stretching and massaging of the nerve?

[54ny77]

i get it on one foot when i'm in a stretch of consistent riding and/or around when i hit 2.5-3 hours on bike (regardless of mileage or terrain, it's more a function of time). and especially when its really hot out.

things i've done:
1) changed to shimano pedals (for its wider platform), which helped a little i think. i used to ride speedplays.

2) use a half size shoe larger than i otherwise would, and leave the affected foot straps fairly loose. this i found helps the most. it's especially important to keep shoe strap closest to ankle as loose as possible, supposedly there's a vein or nerve right there that is the starting point for things going wrong. i use shimano wide shoes.

doing these things have helped a bit. not a lot, but incremental improvements.

while i can live with the pain up to a certain threshold, when/if it gets really bad, i simply have to pull over and take a 10 minute break and massage my foot very firmly. that will typically buy me about 40 or so min. of minimal pain free riding so i can get home.

i've read plenty of stories about custom shoes being a mixed bag, and given how often i'm on the bike for 3+ hours, it's not worth it to me to spend the $$$$ for that kind of shoe. at this time, at least.

[oldguy00]

Originally Posted by 54ny77

i get it on one foot when i'm in a stretch of consistent riding and/or around when i hit 2.5-3 hours on bike (regardless of mileage or terrain, it's more a function of time). and especially when its really hot out.

things i've done:
1) changed to shimano pedals (for its wider platform), which helped a little i think. i used to ride speedplays.

2) use a half size shoe larger than i otherwise would, and leave the affected foot straps fairly loose. this i found helps the most. it's especially important to keep shoe strap closest to ankle as loose as possible, supposedly there's a vein or nerve right there that is the starting point for things going wrong. i use shimano wide shoes.

doing these things have helped a bit. not a lot, but incremental improvements.

while i can live with the pain up to a certain threshold, when/if it gets really bad, i simply have to pull over and take a 10 minute break and massage my foot very firmly. that will typically buy me about 40 or so min. of minimal pain free riding so i can get home.

i've read plenty of stories about custom shoes being a mixed bag, and given how often i'm on the bike for 3+ hours, it's not worth it to me to spend the $$$$ for that kind of shoe. at this time, at least.

Thanks. Yeah I'm on speedplay too and notice more than ever my feet wanting to pull to the outside, rocking, and find my toes wanting to 'grab'. The inside of my leg, along the post tib tendon area above the ankle actually starts to get tired.
I've tried Shimano and like the larger platform, but I didn't like the float, even on their 6 degree cleats, compared to what I was used to with speedplay.
So I just took delivery of a pair of Look Keo Carbons, and a set of their 9 degree cleats. Haven't tried them yet, but will soon.

[wallymann]

at podiatrists suggestion...i just grab each of those middle toes and lift up and down and move each one individually thru a wide range of motion in all directions. does seems to limber things up a little and prep the nerve for whatever abuse comes next.

as i sit here i can poke a finger at that nerve to elicit a small jolt into my toes! so the neuroma is still there and will probably always be, but it is manageable and much better than it was in years past.

Originally Posted by oldguy00

Wallymann - what do you do for stretching and massaging of the nerve?

[steamer]

Custom, handmade met pads made out of moleskin and not wearing shoes that are too narrow up front solved mine.

[verbs4us]

Not an expert, but living with this kind of foot pain/discomfort for several years. After some research, I found that sometimes an L5 nerve root irritation can masquerade as (classic) Morton's Neuroma. Even without a sciatica-type shooting pain or tingling. Under PT supervision, experimenting now with "flossing," which is gentle stretching, once a day, an an attempt to unimpinge a possible impingement affecting L5. Signs are promising: what was numbness is now tingling, which suggests some nerve recovery. Or psychosomatic effectiveness! If you see a foot doc, they will see a foot problem; if you see a physiatrist, they will take a more system-wide view.

[Hellgate]

I'm going in for surgery in 2 weeks. I'm tired of dealing with this for the past 3 years. I have a total of three shoes I can wear, including my cycling cleats. The Lake CX241s have been a godsend.

[soulspinner]

Originally Posted by Hellgate

I'm going in for surgery in 2 weeks. I'm tired of dealing with this for the past 3 years. I have a total of three shoes I can wear, including my cycling cleats. The Lake CX241s have been a godsend.

Good luck and let us know how it comes out...…...